Remote Inpatient Utilization Management Specialist

Cambia Health Solutions; Coeur d'Alene (ID); Remote; USD 50,000 - 81,000; Full time

Benefits offered by this job

Medical, dental and vision coverage

401(k) with company match

Paid time off and holidays

Parental leave

Job summary

Cambia Health Solutions is seeking a remote UM IP Clinical Specialist to review inpatient utilization management requests, gather information, and coordinate with licensed clinicians. You will help ensure accurate case documentation, timely action, and clear communications with providers and internal teams.

The role emphasizes collaboration, accuracy, and compliance with federal and state regulations, while supporting our members’ care journeys in a fast-paced environment.

Qualifications

• High school diploma or equivalent.
• Clinical experience is required.
• At least 2 years of clinical experience preferred.
• CMA or CNA preferred.

Responsibilities

• Research IP UM requests and take action to obtain necessary details while closing cases accurately.
• Communicate effectively with providers and team members and prepare written notifications in compliance with regulations.
• Maintain timeliness and quality to meet regulatory requirements and corporate standards for accuracy.

Skills

Clinical experience

Inpatient setting

Communication skills

EMR

Medical terminology

Education

High school diploma

CMA or CNA preferred

Tools

Microsoft Office

Outlook

EMR systems

Job description

Cambia Health Solutions is seeking a remote UM IP Clinical Specialist to review inpatient utilization management requests, gather information, and coordinate with licensed clinicians. You will help ensure accurate case documentation, timely action, and clear communications with providers and internal teams.

The role emphasizes collaboration, accuracy, and compliance with federal and state regulations, while supporting our members’ care journeys in a fast-paced environment.